Background Research suggests that addressing dying patients' existential concerns can help improve their quality of life. Common existential conditions, such as a search for meaning and considerations about faith, are probably intensified in a palliative setting and existential concerns about death are likewise intensified when patients face their impending death. Knowledge of modern, secular existential concerns about death is under-researched, and therefore, it is difficult to develop and implement specifically targeted support to dying patients.
Aim The aim of this paper is to present the results from a qualitative field study illuminating the variety of dying patients´ existential concerns about their impending death.
Method Data was generated through ethnographic fieldwork comprising 17 semi-structured interviews with dying patients and 38 days of participant observation at three Danish hospices.
Results The analyses of interview data revealed two categories of existential concerns. The first category “Thoughts and feelings about death” demonstrated how the patients: 1) realized the forthcoming death; 2) felt sorrow about leaving life; 3) were not anxious about death as a final state. The second category “Managing death” demonstrated how the patients: 1) avoided thinking about death; 2) reconstructed individual ideas about afterlife on the basis of faith and previous cultural meaning-making; 3) were planning practical aspects about death; 4) wished to focus on living. The patients' existential concerns of death in a modern, secular setting is not adequately described by neither Irvin Yalom's existential psychology nor Kübler-Ross' theory about death stages. The complex concerns might be explained in the light of research in everyday life based on Martin Heidegger's phenomenological thinking.
Conclusion The analyses indicated that the patients' concerns were complex, contradictory and not suited to be understood within a single theory. An ongoing reflection including different theoretical perspectives seems important when providing existential care and support to dying patients.